tci Medicare Compliance & Reimbursement - 2015 Issue 8

Overpayments: Keep A Close Watch On These Overpayment-Related Court Cases

How outcome of lawsuits could impact 60-day rule. The fact that the Centers for Medicare & Medicaid Services (CMS) has yet to finalize the 60-day overpayment rule apparently hasn’t stopped the U.S. Department of Justice (DOJ) from moving forward with recovering overpayments according to  the 60-day timeframe.   Case in point: The DOJ intervened in a False Claims Act (FCA) whistleblower (qui tam) case that alleges the defendants failed to return Medicaid overpayments within 60 days, as mandated by the Affordable Care Act (ACA). The DOJ alleges that Continuum Health Partners, which operates Beth Israel Medical...

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